Eating disorders are widely recognized as some of the most challenging psychological diagnoses. I was surprised to learn that they are also the most dangerous: eating disorders have the highest mortality rate of any diagnosis. Many clinicians assume that eating disorders only occur in young women. However, research has shown that the frequency of eating disorders is rising across a wide range of client populations, including men, middle-aged, and the elderly. Regardless of the population you work with, sooner or later you will encounter clients with eating disorders.

How can a clinician get training to help clients with eating disorders? I recently discussed this with Deborah Brenner-Liss, PhD, the director of the Association of Professionals Treating Eating Disorders (APTED). APTED is an affiliation of eating disorder specialists based in the San Francisco Bay Area. APTED provides support and training for clinicians, and referrals and direct service for clients.

APTED emphasizes a multi-modal method of treating eating disorders, including trauma, attachment-focused, somatic, experiential and affect-focused treatments. Given the complexity of eating disorder ontology and treatment, Dr. Brenner-Liss encourages students to “enlarge the depth of their conceptualizations”. APTED treatment includes a wide range of providers in the treatment team, including therapists, social workers, physicians, psychiatrists, nutritionists, body workers and coaches. (I personally find this to be a welcome relief from the all-too-common clinical turf battles!)

For clients with sub-clinical eating disorders, Dr. Brenner-Liss recommends consulting with an eating disorder specialist. Like other addictions, eating disorders are behaviors that build over time, and can sometimes be arrested in the early stages if they are addressed early with serious treatment.

For clinicians who want to work with clinical-level eating disorders, Dr. Brenner-Liss recommends getting formal training. In the San Francisco Bay Area, both UC Berkeley extension and JFK University provide eating disorder certificates. For those in other areas, the International Association of Eating Disorders Professionals Foundation (IAEDP) provides an online training and certification course (http://www.iaedp.com/). The IAEDP course includes readings, audio records from IADEP conferences, and writing assignments. I am currently taking this course myself, and have found it very rich.

Dr. Brenner-Liss also recommends joining a eating disorder-focused consultation in order to get exposure to a wide range of case material. Likewise, attending a weekly 12-step eating disorder group for a few months can provide valuable insight into the nature and course of eating disorders. Most ED groups are “open” so clinicians can be a “fly on the wall.”

For those in the SF Bay Area, APTED is hosting a two-day conference, “Re-Finding Our Way to Wholeness: What heals? Eating Disorders and Trauma,” September 24-25th, 2011, in Berkeley. Registration required by September 10th. For more info, call 415-608-6307, or e-mail AptedSF@aol.com. Notably, the conference is open to both clinicians and individuals in recovery. I am personally encouraged by the growing movement in the psychotherapy community to break down the barriers between providers and clients. (Another notable recent example is the Marsha Linehan's courageous self-disclosure about her struggle with mental illness.)